synostosis

Synostosis refers to the premature fusion of bones that are normally separated by cartilaginous or fibro-osseous connections [8]. This condition can occur physiologically, as an asymptomatic anatomical variant, or it may be abnormal and cause clinical symptoms due to a functional loss [8].

In the context of craniosynostosis, synostosis involves the early fusion of one or more of the fibrous sutures in a young infant's skull, leading to altered growth patterns and potential misshapen head shapes [11][12]. The premature closure of cranial sutures can result in the skull growing on the path of least resistance, perpendicular to the closed suture, causing structural changes and potentially affecting brain development [12].

Synostosis can affect various bones and joints, including those in the skull, limbs, and spine. It is essential to note that synostosis is a generic term, and its presentation can vary depending on the degree of joint development and the amount of fusion involved [3]. The condition can range from full mobility to complete bony union between normally separate bones [3].

In some cases, synostosis may not cause any noticeable symptoms or issues. However, in more severe instances, it can lead to functional impairments, pain, or other complications [8].

Common Signs and Symptoms of Synostosis

Synostosis, also known as craniosynostosis, is a condition where one or more of the fibrous sutures in an infant's skull fuse together prematurely. This can lead to various signs and symptoms, which can vary depending on the type and severity of the condition.

Common Signs:

• A misshapen skull, with the shape depending on which suture is affected [1]
• No fontanelle (soft spot) on a baby's head where the skull hasn't closed [2]
• A change in the normal shape of the head and face [11]

Common Symptoms:

• Inconsolable crying or fussiness [8]
• Being very sleepy or not very active [8]
• A bulging fontanel (soft spot) on the head [8]
• The soft spot on your baby's head (fontanelle) disappears early or bulges [9]
• A raised ridge develops along the fused suture [9]

Other Possible Symptoms:

• Slow growth or no growth in the affected area [5]
• Trigonocephaly, where the top of the baby's head may appear narrow in the front and broad in the back [5]
• Increased pressure within the skull, which can lead to symptoms such as:
  • Headaches
  • Vomiting
  • Irritability
  • Poor feeding habits [6]

Important Note:

It is essential to consult a child's doctor for a proper diagnosis and treatment plan. The symptoms of synostosis may resemble other conditions or medical problems, so it's crucial to seek professional advice.

References:

[1] Signs and severity depend on how many sutures are fused and when in brain development the fusion occurs. [2] What are the symptoms and signs of craniosynostosis? [5] Metopic synostosis [6] Occasionally, synostosis can increase pressure within the skull. [8] Symptoms of craniosynostosis may vary, depending on which sutures in the skull are involved and how advanced the condition is when it’s diagnosed. [9] What are the symptoms of craniosynostosis? [11] Craniosynostosis Symptoms. In infants with this condition, the most common signs are changes in the shape of the head and face.

Diagnostic Tests for Craniosynostosis

Craniosynostosis can be diagnosed through a combination of physical examination and diagnostic testing. Here are some of the common tests used to confirm the diagnosis:

• Physical Examination: A thorough physical exam by a pediatric neurosurgeon or a specialist in plastic and reconstructive surgery is usually the first step in diagnosing craniosynostosis. The healthcare provider will look for features such as suture ridges, facial differences, and other signs of premature skull fusion.
• Computed Tomography (CT) Scans: CT scans use x-ray equipment and powerful computers to create detailed images of the head and brain, including skull sutures and bones. This test can help confirm the diagnosis by showing the details of the fused suture(s).
• X-rays: X-rays may be used to check for pressure inside the head, fused sutures, or ridges along sutures.
• Genetic Tests: Genetic tests may be performed to check for syndromes associated with craniosynostosis. A clinical geneticist will perform a physical examination and conduct genetic testing to determine if the condition is nonsyndromic or syndromic.

Types of Diagnostic Tests

The type of diagnostic test used will depend on the individual case. Some common types of diagnostic tests include:

• CT scans: CT scans are often used to confirm the diagnosis by showing the details of the fused suture(s).
• X-rays: X-rays may be used to check for pressure inside the head, fused sutures, or ridges along sutures.
• Genetic testing: Genetic testing may be performed to check for syndromes associated with craniosynostosis.

References

1. [3] Computed tomography (CT) scans use x-ray equipment and powerful computers to create detailed images of the head and brain, including skull sutures and bones.
2. [9] Diagnostic imaging, especially CT scans, to check for pressure inside the head, fused sutures, or ridges along sutures.
3. [14] A complete physical exam; X-rays of the head; A CT scan of the head may be ordered by your child's pediatrician to confirm the diagnosis.

Note: The numbers in square brackets refer to the context numbers provided above.

Treatment Options for Synostosis

Synostosis, also known as craniosynostosis, is a condition where one or more of the fibrous sutures in an infant's skull fuse together prematurely. While there are no specific "drugs" that can treat synostosis, treatment options do exist to help manage the condition.

Surgical Intervention

The primary treatment for synostosis is surgical intervention, which involves opening the fused suture(s) to create space for brain growth and development [10]. This procedure is usually performed by a neurosurgeon or a craniofacial surgeon. The goal of surgery is to release the pressure on the brain and allow it to grow normally.

Helmet Therapy

In some cases, helmet therapy may be recommended as an alternative to surgery. A specially molded helmet can help reshape the baby's head if the cranial sutures are open and the head is misshapen [1]. This type of therapy can assist in correcting the shape of the skull while allowing the brain to grow and develop normally.

Other Treatment Options

While there are no specific "drugs" that can treat synostosis, other treatment options may be considered on a case-by-case basis. These may include physical and occupational therapy to help children with synostosis meet normal developmental milestones [7]. In some cases, mobilization procedures or reconstruction of the affected area may also be recommended [8].

Importance of Early Detection

Early detection and treatment are crucial in managing synostosis. If left untreated, the condition can lead to developmental delays and other complications [10]. Therefore, it is essential for parents to work closely with their healthcare provider to determine the best course of action for their child.

References:

[1] Context result 1 [7] Context result 7 [8] Context result 8 [10] Context result 10

Differential Diagnosis of Synostosis

Synostosis, also known as craniosynostosis, refers to the premature fusion of one or more cranial sutures in infants and children. The differential diagnosis of synostosis involves identifying other conditions that may present with similar symptoms.

Conditions to Consider:

• Positional Plagiocephaly: This is a condition where the head shape is asymmetrical due to external pressure, such as from sleeping on one side. It can be differentiated from craniosynostosis by the absence of premature suture fusion.
• Benign Skull Tumors: These are rare conditions that can cause an abnormal head shape, but they do not involve premature suture fusion.
• Chronic Myelogenous Leukemia: This is a type of cancer that can affect the skull and cause an abnormal head shape, but it is not related to synostosis.

Key Differences:

• Suture Fusion: Synostosis involves the premature fusion of cranial sutures, whereas positional plagiocephaly does not.
• External Pressure: Positional plagiocephaly is caused by external pressure on the skull, whereas synostosis is a result of abnormal bone growth.

Importance of Accurate Diagnosis:

Accurate diagnosis of synostosis is crucial to determine the best course of treatment. Surgical correction may be necessary in cases of synostosis, but it is not required for positional plagiocephaly or other conditions that mimic its symptoms.

References:

• [4] The correct differential diagnosis of an abnormal head shape in an infant or a child is vital to the management of this common condition.
• [11] Positional plagiocephaly requires differentiation from craniosynostosis. It has no premature fusion of sutures.
• [12] The differential diagnosis of DP includes unilateral coronal and unilateral lambdoid craniosynostosis, both described above.
• [13] Craniosynostosis refers to the premature closure of sutures of the skull and results in an abnormal head shape.